右美托咪定肺保护作用的研究进展

doi:10.12337/zgkqjxjyzz.2023.06.011

中国口腔医学继续教育杂志 ›› 2023, Vol. 26 ›› Issue (6): 442-448.DOI: 10.12337/zgkqjxjyzz.2023.06.011

右美托咪定肺保护作用的研究进展

刘云, 杨旭东^*

北京大学口腔医学院·口腔医院麻醉科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室

出版日期:2023-11-30 发布日期:2024-03-13
通讯作者: ^*杨旭东,联系方式：010-82195287,电子邮箱：kqyangxudong@163.com,通讯地址：北京市海淀区中关村南大街22号,100081
基金资助:
重庆医科大学2022年未来医学青年创新团队发展支持计划项目（项目编号：W0147）

Research Progress on the Effects of Dexmedetomidine on Lung Protection

Yun Liu, Xudong Yang^*

Department of Anesthesiology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, P.R. China

Online:2023-11-30 Published:2024-03-13
Contact: ^*Xudong Yang. Tel: 010-82195287. Email: kqyangxudong@163.com. Address: No. 22, Zhongguancun South Street, Haidian District, Beijing 10081, P.R. China.
Supported by:
Fujian Natural Science Foundation Identification of DNA damage repair genes related to the prognosis of Oral cancer(2020J012)

摘要/Abstract

摘要： 既往研究表明,右美托咪定可与人体肾上腺素能受体α₂结合,有镇静、镇痛、抑交感的作用,通过抗炎、抗氧化应激及调控细胞凋亡和自噬等作用减轻各类肺损伤。本文将围绕右美托咪定的肺保护作用进行详细而全面的综述。

关键词: 右美托咪定, 肺, 肺保护, 机制, 进展

Abstract: Previous studies have shown that dexmedetomidine（DEX） can bind to adrenergic receptor (AR) α₂, have sedative, analgesic, sympathetic effects, and reduce various lung injuries by anti-inflammatory, oxidative stress and regulate apoptosis and autophagy. A detailed and comprehensive review will be conducted around the lung protective effect of DEX.

Key words: dexmedetomidine, lung, lung protection, mechanism, research progress

刘云, 杨旭东. 右美托咪定肺保护作用的研究进展[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 442-448.

Yun Liu, Xudong Yang. Research Progress on the Effects of Dexmedetomidine on Lung Protection[J]. Chinese Journal of Stomatological Continuing Education, 2023, 26(6): 442-448.

参考文献

[1] Bao N, Tang B.Organ-Protective Effects and the Underlying Mechanism of Dexmedetomidine[J].Mediators Inflamm. 2020; 2020:6136105.
[2] Ng KT, Shubash CJ, Chong JS.The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis[J]. Anaesthesia. 2019; 74(3):380-392.
[3] Peng K, Ji FH, Liu HY, et al. Effects of Perioperative Dexmedetomidine on Postoperative Mortality and Morbidity: A Systematic Review and Meta-analysis[J]. Clin Ther.2019; 41(1):138-154.e4.
[4] Ma J, Chen Q, Li J, et al.Dexmedetomidine-Mediated Prevention of Renal Ischemia-Reperfusion Injury Depends in Part on Cholinergic Anti-Inflammatory Mechanisms[J]. Anesth Analg. 2020; 130(4):1054-1062.
[5] Portelli K, Kandraju H, Ryu M, et al. Efficacy and safety of dexmedetomidine for analgesia and sedation in neonates: a systematic review[J]. J Perinatol.2023 Oct 16. doi: 10.1038/s41372-023-01802-5. Epub ahead of print.
[6] Li J, Dou X, Li D, et al.Dexmedetomidine Ameliorates Post-CPB Lung Injury in Rats by Activating the PI3K/Akt Pathway[J]. J Invest Surg. 2020; 33(6):576-583.
[7] Wang K, Wu M, Xu J, et al.Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis[J]. Br J Anaesth. 2019; 123(6):777-794.
[8] Bo JH, Wang JX, Wang XL, et al.Dexmedetomidine Attenuates Lipopolysaccharide-Induced Sympathetic Activation and Sepsis via Suppressing Superoxide Signaling in Paraventricular Nucleus[J]. Antioxidants (Basel). 2022; 11(12):2395.
[9] Tanyeli A, Guzel Erdogan D, Comakli S,et al.Therapeutic effects of apocynin on ovarian ischemia-reperfusion induced lung injury[J]. Biotech Histochem. 2022; 97(7):536-545.
[10] 陈月, 张加强, 孟凡民. 右美托咪定对肢体缺血再灌注诱发肺损伤的影响[J]. 中国医院药学杂志, 2015, 35(12):1113-1115.
[11] Li Y, Liu S.The Effect of Dexmedetomidine on Oxidative Stress Response Following Cerebral Ischemia-Reperfusion in Rats and the Expression of Intracellular Adhesion Molecule-1 (ICAM-1) and S100B[J]. Med Sci Monit. 2017; 23:867-873.
[12] Chen Y, Bian W, Xu B.Pretreatment with dexmedetomi-dine alleviates lung injury in a rat model of intestinal ischemia reperfusion[J]. Mol Med Rep. 2020; 21(3):1233-1241.
[13] Li J, Chen Q, He X, et al.Dexmedetomidine attenuates lung apoptosis induced by renal ischemia-reperfusion injury through α2AR/PI3K/Akt pathway[J]. J Transl Med. 2018; 16(1):78.
[14] 于健, 李睿, 姚文瑜. 右美托咪啶预处理对下肢缺血再灌注致肺损伤的保护作用[J]. 中华医学杂志, 2014, 94(44):3510-3514.
[15] Bai YX, Zhang JH, Zhao BC, et al.Dexmedetomidine attenuates one-lung ventilation associated lung injury by suppressing inflammatory responses: A systematic review and meta-analysis[J]. Clin Exp Pharmacol Physiol. 2021; 48(9):1203-1214.
[16] 韩冰, 陈梦婷, 杨传铭, 等. 右美托咪定预处理通过抑制NLRP3炎性小体激活减轻大鼠肠缺血再灌注诱导的急性肺损伤[J]. 南方医科大学学报, 2021, 41(12): 1857-1863.
[17] Wang L, Ding Y, Bai Y, et al.The activation of SIRT3 by dexmedetomidine mitigates limb ischemia-reperfusion-induced lung injury[J]. Ann Transl Med. 2022; 10(6):319.
[18] Chen H, Sun X, Yang X, et al.Dexmedetomidine reduces ventilator-induced lung injury (VILI) by inhibiting Toll-like receptor 4 (TLR4)/nuclear factor (NF)-κB signaling pathway[J]. Bosn J Basic Med Sci. 2018; 18(2):162-169.
[19] Xue BB, Chen BH, Tang YN, et al.Dexmedetomidine protects against lung injury induced by limb ischemia-reperfusion via the TLR4/MyD88/NF-κB pathway[J]. Kaohsiung J Med Sci. 2019; 35(11):672-678.
[20] Meng L, Li L, Lu S, et al.The protective effect of dexmedetomidine on LPS-induced acute lung injury through the HMGB1-mediated TLR4/NF-κB and PI3K/Akt/mTOR pathways[J]. Mol Immunol. 2018; 94:7-17.
[21] Zhang H, Sha J, Feng X, et al.Dexmedetomidine ameliorates LPS induced acute lung injury via GSK-3β/STAT3-NF-κB signaling pathway in rats[J]. Int Immunopharmacol. 2019; 74:105717.
[22] Wang R, Xie Y, Qiu J, et al.The Effects of Dexmedetomidine in a Rat Model of Sepsis-Induced Lung Injury are Mediated Through the Adenosine Monophosphate-Activated Protein Kinase (AMPK)/Silent Information Regulator 1 (SIRT1) Pathway[J]. Med Sci Monit. 2020; 26:e919213.
[23] Shao Y, Chen X, Liu Y, et al.Dexmedetomidine alleviates lung injury in sepsis mice through regulating P38 MAPK signaling pathway[J]. Panminerva Med. 2021; 63(4):563-564.
[24] Zhang YN, Chang ZN, Liu ZM, et al.Dexmedetomidine Alleviates Gut-Vascular Barrier Damage and Distant Hepatic Injury Following Intestinal Ischemia/Reperfusion Injury in Mice[J]. Anesth Analg. 2022; 134(2):419-431.
[25] Liu C, Fu Q, Mu R, et al.Dexmedetomidine alleviates cerebral ischemia-reperfusion injury by inhibiting endoplasmic reticulum stress dependent apoptosis through the PERK-CHOP-Caspase-11 pathway[J]. Brain Res. 2018; 1701:246-254.
[26] 宋冬, 罗梓垠, 项冰倩, 等. 右美托咪定通过抑制UPR凋亡通路减轻小鼠缺血/再灌注肺损伤[J]. 中国病理生理杂志, 2015, 31(10):1909.
[27] 陈丹, 宋冬, 叶玉柱, 等. 右美托咪定通过影响CHOP凋亡通路减轻缺血/再灌注肺损伤[J]. 中国病理生理杂志, 2015, 31(6):1093-1098.
[28] Fu C, Dai X, Yang Y, et al.Dexmedetomidine attenuates lipopolysaccharide-induced acute lung injury by inhibiting oxidative stress, mitochondrial dysfunction and apoptosis in rats[J]. Mol Med Rep. 2017; 15(1):131-138.
[29] 刘贵春, 孙凯, 付红光, 等. 右美托咪啶对老年肺癌患者单肺通气时肺损伤及CHOP蛋白表达的影响[J]. 中华医学杂志, 2020, 100(1):37-41.
[30] Zhang W, Zhang JQ, Meng FM, et al.Dexmedetomidine protects against lung ischemia-reperfusion injury by the PI3K/Akt/HIF-1α signaling pathway[J]. J Anesth. 2016; 30(5):826-833.
[31] 汤旭, 陆克银. PI3K-Akt-HIF-α信号通路在右美托咪定减轻大鼠肝缺血/再灌注致肺损伤中的作用[J]. 北方药学, 2017; 14(7):123-124.
[32] 肖如红, 张忠, 米志华, 等. PI3K/Akt信号传导通路在右美托咪定抗大鼠肢端缺血/再灌注致急性肺损伤中的作用[J]. 北方药学, 2017; 14(1):140-141.
[33] Zhang W, Zhang J.Dexmedetomidine preconditioning protects against lung injury induced by ischemia-reperfusion through inhibition of autophagy[J]. Exp Ther Med. 2017; 14(2):973-980.
[34] Ding D, Xu S, Zhang H, et al.3-Methyladenine and dexmedetomidine reverse lipopolysaccharide-induced acute lung injury through the inhibition of inflammation and autophagy[J]. Exp Ther Med. 2018; 15(4):3516-3522.
[35] Li ZB, Li GC, Qin J.Dexmedetomidine Attenuates Lung Injury in Toxic Shock Rats by Inhibiting Inflammation and Autophagy[J]. Arch Med Res. 2021; 52(3):277-283.
[36] Meyer NJ, Gattinoni L, Calfee CS.Acute respiratory distress syndrome[J]. Lancet. 2021; 398(10300):622-637.
[37] Kong Q, Wu X, Qiu Z, et al.Protective Effect of Dexmedetomidine on Acute Lung Injury via the Upregulation of Tumour Necrosis Factor-α-Induced Protein-8-like 2 in Septic Mice[J]. Inflammation. 2020; 43(3):833-846.
[38] Zhang Q, Wu D, Yang Y, et al.Dexmedetomidine Alleviates Hyperoxia-Induced Acute Lung Injury via Inhibiting NLRP3 Inflammasome Activation[J]. Cell Physiol Biochem. 2017; 42(5):1907-1919.
[39] Zhang Y, Jia S, Gao T, et al.Dexmedetomidine mitigate acute lung injury by inhibiting IL-17-induced inflammatory reaction[J]. Immunobiology. 2018; 223(1):32-37.
[40] Wang WB, Li JT, Hui Y, et al.Combination of pseudoephedrine and emodin ameliorates LPS-induced acute lung injury by regulating macrophage M1/M2 polarization through the VIP/cAMP/PKA pathway[J]. Chin Med. 2022; 17(1):19.
[41] Felten M, Ferencik S, Teixeira Alves LG,et al.Ventilator-induced Lung Injury Is Modulated by the Circadian Clock[J]. Am J Respir Crit Care Med. 2023; 207(11):1464-1474.
[42] Zhang B, Zhang X, Li Q, et al.Dexmedetomidine attenuates ventilator-induced lung injury in rats by up-regulating NLRC3[J]. Ann Palliat Med. 2020; 9(5):2474-2484.
[43] Chen-Yoshikawa TF.Ischemia-Reperfusion Injury in Lung Transplantation[J]. Cells. 2021; 10(6):1333.
[44] Wang X, Zhang B, Li G, et al.Dexmedetomidine Alleviates Lung Oxidative Stress Injury Induced by Ischemia-Reperfusion in Diabetic Rats via the Nrf2-Sulfiredoxin1 Pathway[J]. Biomed Res Int. 2022; 2022:5584733.
[45] 韩佳韫, 吴俊晶, 韩超. 丙泊酚与右美托咪定全凭静脉麻醉对食管癌根治术患者肺氧合功能及肺部并发症的影响[J]. 山东医药, 2017, 57(5):65-67.
[46] 蒋柳明, 周森, 卓谦, 等. 右美托咪定预先给药下调HMGB1和sRAGE水平减轻肢体缺血再灌注远隔肺损伤[J]. 中国新药与临床杂志, 2017, 36(3):146-150.
[47] Lee SH, Kim N, Lee CY, et al.Effects of dexmedetomi-dine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: A randomised double-blinded trial[J]. Eur J Anaesthesiol. 2016; 33(4):275-282.
[48] 卞清明, 许仄平, 王丽君, 等.肺保护性通气策略联合右美托咪定对胸科手术患者氧化应激反应及术后肺部并发症的影响[J]. 南京医科大学学报(自然科学版), 2018, 38(4):509-513.
[49] 张顺利, 任志明, 李建国. 前列地尔联合右美托咪定预处理对骨骼肌缺血再灌注和继发性肺损伤保护的研究[J]. 重庆医学, 2017, 46(4):453-455.
[50] 毛武德, 崔秀凤, 田莲莲. 右美托咪定防治下肢手术缺血-再灌注致肺损伤33例临床研究[J]. 中国药业, 2018, 27(20):49-51.
[51] Xu B, Gao H, Li D, et al.Nebulized dexmedetomidine improves pulmonary shunt and lung mechanics during one-lung ventilation: a randomized clinical controlled trial[J]. PeerJ. 2020; 8:e9247.
[52] Asri S, Hosseinzadeh H, Eydi M, et al.Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery[J]. Anesth Pain Med. 2020; 10(1):e95287.
[53] Kartal S, Kip G, Küçük A, et al. The Effects of Dexmedetomidine and Ketamine on Oxidative Injuries and Histological Changes Following Blunt Chest Trauma[J]. Drug Des Devel Ther. 2020; 14:2937-2943.
[54] Ming T, Yuan M, Kong Q, et al.Dexmedetomidine alleviates blunt chest trauma and hemorrhagic shock resuscitation induced acute lung injury through inhibiting the NLRP3 inflammasome[J]. Mol Med Rep. 2020; 22(3):2507-2515.

右美托咪定肺保护作用的研究进展

Research Progress on the Effects of Dexmedetomidine on Lung Protection

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价

[1]	刘云, 杨旭东. 口腔门诊镇静镇痛技术的新进展[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 454-458.
[2]	江星, 傅升, 尹昌凡, 樊丽娜. 中西医结合治疗颌面部间隙感染的研究进展[J]. 中国口腔医学继续教育杂志, 2023, 26(5): 356-360.
[3]	邓惠芬, 陈秋宇, 王韵, 肖凤霞, 曾秉辉, 余东升, 廖旭辉. 口腔专科医院成功抢救老年候诊患者心脏骤停1例[J]. 中国口腔医学继续教育杂志, 2023, 26(5): 421-426.
[4]	梁蓉, 侯玉霞. 唇腭裂新生儿术前鼻-牙槽塑形的数字化研究进展[J]. 中国口腔医学继续教育杂志, 2023, 26(3): 186-190.
[5]	李顺艺, 戴丽娜. 新冠疫情期间儿童口腔科门诊学龄前儿童及家长焦虑情绪分析[J]. 中国口腔医学继续教育杂志, 2022, 25(5): 316-324.
[6]	王雨田, 黄国栋, 刘子建, 刘宏伟. 口腔黏膜下纤维性变癌变的研究进展[J]. 中国口腔医学继续教育杂志, 2022, 25(3): 129-135.
[7]	戴丽娜, 蒋丹, 薛慧, 朱晓华, 程建, 宋锦璘. 疫情下口腔医学研究生教学管理的探讨[J]. 中国口腔医学继续教育杂志, 2021, 24(4): 222-226.
[8]	李丹, 崔颖, 钱军, 唐志辉, 侯晓玫. 口腔医师线上继续教育学习状况调查分析[J]. 中国口腔医学继续教育杂志, 2021, 24(4): 247-251.
[9]	程梦琳, 张珊珊, 郑树国. 牙周炎和院内获得性肺炎之间的关联:观察性研究的系统评价和荟萃分析[J]. 中国口腔医学继续教育杂志, 2020, 23(5): 257-263.
[10]	李雪铃, 古丽莎, 王润夫, 陆小苹, 周玉竹. 新冠肺炎防疫期口腔急诊患者心理焦虑及干预建议[J]. 中国口腔医学继续教育杂志, 2020, 23(4): 199-206.